BACKGROUND

Among all intraluminal endoscopic treatments for patients with achalasia cardia (AC), endoscopic balloon pneumacardiodilation (EBPD) and peroral endoscopic myotomy (POEM) are the most interesting.

OBJECTIVE

To study and compare immediate and long-term results of EBPD and POEM in patients with AC on the basis of prospective randomized study.

MATERIAL AND METHODS

The study included 25 patients with AC of the 1^st or 2^nd types according to Chicago classification, who had the 2^nd or 3^rd stage of the disease according to B.V. Petrovsky. After detailed examination all patients were divided into two groups by the stratification block randomization method: in group 1 EBPD was performed, in group 2 — POEM.

RESULTS

In group 1 11 EBPD were performed, in group 2 — 14 POEM. All interventions were performed without complications. The mean and absolute duration of EBPD, as well as the duration of hospitalization in group 1 (26.4±9.6 min; 50 min; 3.6±0.9 days) were statistically significantly shorter than in group 2 patients who underwent POEM (96.8±49.1 min; 180 min; 7.0±2.1 days) (p<0.01). All interventions resulted in the relief of dysphagia phenomena. According to the results of clinical and instrumental examination after 1 month, no statistical differences were found in patients of both groups. In 12 months after single EBPD recurrence of AC was registered in 45.4% of patients; after POEM no cases of disease recurrence were registered, and endoscopic signs of terminal esophagitis stage A were revealed in 8.3% of cases.

CONCLUSION

EBPD has advantages over POEM according to the results of evaluation of immediate treatment results, similar clinical effect in the nearest period, but it is considerably inferior to POEM with respect to the reduction of clinical symptoms of AC: 12 months after a single EBPD 43.4% of cases of disease recurrence were registered, while no similar observations were made after POEM.